title: Self-reported family history in estimating the risk of hormone, surgery and cast related VTE in women.
abstract: BACKGROUND
  Combined hormonal contraceptives, menopause hormone treatment and surgery/cast in orthopedic patients are important risk factors for venous thromboembolism (VTE) in women.
  
  
  OBJECTIVE
  To evaluate whether self-reported family history can be used for risk assessment concerning hormone and surgery /cast related VTE in women.
  
  
  METHODS
  1288 women 18-64 years with a first event of VTE and 1327 age-matched controls were included in a nation-wide population-based case-control study in Sweden. Odds ratios were calculated by comparing occurrence of VTE in women with and without a positive family history in combination with hormones or surgery/cast.
  
  
  RESULTS
  The risk of hormone-associated VTE was doubled in women with a family history of VTE as compared to women with hormones and negative family history. The risk was more than tripled in women with surgery/cast and a positive family history, as compared to surgery/cast patients with negative family history. Women with a positive family history and combined hormonal contraceptive or menopause hormone treatment had an OR of 15.3 (95% CI 6.1-38) and 5.9 (95% CI 3.3-11) respectively compared to women without hormones or family history. The corresponding OR in women with surgery/cast and a positive family history was 67 (95% CI 21-213) compared to women without surgery/cast treatment and a negative family history.
  
  
  CONCLUSIONS
  Self-reported family history is associated with increased odds of developing VTE on combined hormonal contraceptives, menopause hormone treatment and in connection with surgery or plaster. We believe that assessing family history of VTE can be helpful in identifying high risk patients.
authors.affiliation: Department of Clinical Science and Education, Internal medicine, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. Electronic address: kristina.sonnevi@sodersjukhuset.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sonnevi
authors.forename: Annica
authors.initials: A
authors.lastname: Bergendal
authors.forename: Johanna
authors.initials: J
authors.lastname: Adami
authors.forename: Gerd
authors.initials: G
authors.lastname: Lärfars
authors.forename: Helle
authors.initials: H
authors.lastname: Kieler
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003276:Contraceptives, Oral / Q000008:administration & dosage* / Q000009:adverse effects; D005192:Family Health; D005260:Female; D005838:Genotype; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D057566:Self Report; D013548:Sweden / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000235:genetics; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral
keywords: Estrogens; Family History; Risk factors; Venous Thromboembolism; Women